WGU D119 PEDIATRIC PRIMARY CARE
Comprehensive Resource To Help You Ace 2026-
2027 Includes Frequently Tested Questions With
ELABORATED 100% Correct COMPLETE SOLUTIONS
Guaranteed Pass First Attempt!!
Current Update!!
1. A 3-year-old child is diagnosed with pediculosis capitis. What is the
recommended initial treatment?
A. Oral ivermectin
B. Lindane shampoo
C. Permethrin 1% topical lotion
D. Malathion 0.5% lotion
Correct Answer: C. Permethrin 1% topical lotion
2. A 7-month-old infant has had two prior episodes of acute otitis media
and is currently on day 10 of amoxicillin-clavulanate after failure of
amoxicillin. Examination reveals persistent middle ear effusion and
erythematous tympanic membranes. The infant is irritable with a
temperature of 99.8°F (37.7°C). What is the next step in management?
A. Switch to oral azithromycin
B. Administer intramuscular ceftriaxone
C. Continue antibiotics for an additional 7 days
D. Refer the child to an otolaryngologist
Correct Answer: D. Refer the child to an otolaryngologist
,3. A child presents with bilateral ear itching, hearing difficulty,
periauricular edema, and marked swelling of the external auditory canal.
Severe pain is elicited with manipulation of the auricle. What is the most
appropriate intervention?
A. Oral amoxicillin
B. Oral antihistamines
C. Ototopical antibiotic-corticosteroid drops
D. Ear irrigation
Correct Answer: C. Ototopical antibiotic-corticosteroid drops
4. A child previously treated with amoxicillin followed by amoxicillin-
clavulanate for acute otitis media is seen for follow-up. Examination shows
dull gray tympanic membranes with a visible air-fluid level. The child is
afebrile and asymptomatic. What is the appropriate next action?
A. Begin a third course of antibiotics
B. Refer to otolaryngology immediately
C. Monitor the middle ear effusion for up to 3 months
D. Prescribe antihistamines and decongestants
Correct Answer: C. Monitor the middle ear effusion for up to 3 months
5. A school-age child with a history of chronic otitis media presents with
vertigo. Examination reveals profuse purulent otorrhea from pressure-
equalizing tubes and a pearly white lesion on the tympanic membrane.
What is the most likely diagnosis?
A. Otitis externa
B. Mastoiditis
C. Tympanosclerosis
D. Cholesteatoma
Correct Answer: D. Cholesteatoma
6. What teaching should the Family Nurse Practitioner provide to parents of
a child who has new pressure-equalizing tubes (PETs) placed in both ears?
, A. Water exposure must be avoided at all times
B. Recurrent ear infections will never occur again
C. Hearing improvement should be expected
D. Tubes must be surgically removed within 6 months
Correct Answer: C. Hearing improvement should be expected
7. A nurse practitioner observes multiple oval macules, both
hyperpigmented and hypopigmented, on a child’s upper trunk. A fine scale
is noted at the borders of the lesions. What is the most likely diagnosis?
A. Vitiligo
B. Pityriasis rosea
C. Tinea versicolor
D. Atopic dermatitis
Correct Answer: C. Tinea versicolor
- tinea versicolor is a common dermatosis characterized by multiple small,
oval, scaly patches measuring 1-3 cm in diameter, usually located in a
raindrop pattern on the upper chest, back, and proximal portions of the
upper extremities. In children, atopic dermatitis lesions are typically dry,
papular, and intensely pruritic. Circumcised scaly patches are distributed on
the wrists, ankles, and antecubital and popliteal fossa.
- Keratosis pilaris is typically distributed on the posterior upper portion of the
arms and lesions are dry and papular.
- With Pityriasis rosea, a prodrome of malaise, headache, and mild
constitutional symptoms occasionally precedes the rash but it's not crucial
for diagnosis. The typical eruption begins with the appearance of one or
multiple "Herald patches" which are large, isolated, oval lesions, usually
pink in color and slightly scaly. They may occur anywhere on the body. From
5 to 10 days later, other smaller oval lesions appear on the body, frequently
concentrated over the truck but also seen on the proximal extremities,
especially the thighs
, 8. The NP is examining a 6-week-old infant of Latin American descent. There
are irregular areas of Deep Blue pigmentation across the infant's buttocks.
This would be identified as a characteristic of: - ANSWER Mongolian
spots;
- this best describes Mongolian spots, which are characteristic in newborns
of African, Asian, or Latin descent. When closely evaluated, these but do
not resemble the ecchymosis that occurs with trauma. Telangiectatic nevi
are commonly known as "stork bites" and our deep pink lesions most often
found on the back of the neck. Cutis marmorata is the transient mottling
that occurs when an infant is cold
9. A new mother is concerned about the Hemangioma on her infant's neck.
What is the treatment of choice for the majority of infants with
hemangioma? - ANSWER Observation
- the most common treatment is observation because most hemangiomas
resolve over time, usually beginning at about 18 months of age. The other
treatments may be perform, especially for hemangiomas proliferating rapidly.
Treatment with Propranolol, topical, or laser therapy may be used. Propranolol
is generally initiated inpatient, with nursing supervision of blood pressure and
heart rate and blood glucose.
10.A mother brings her preschool child to see the FNP because of sores on his
arms and legs. On exam, the FNP notes several honey-colored crusted
lesions within an erythematous base on the arms and legs. There's a history
of exposure to mosquitoes. The rest of the exam is essentially negative.
What is the most likely diagnosis? - ANSWER impetigo; impetigo
presents with honey-colored crusted lesions with an erythematous base.
Comprehensive Resource To Help You Ace 2026-
2027 Includes Frequently Tested Questions With
ELABORATED 100% Correct COMPLETE SOLUTIONS
Guaranteed Pass First Attempt!!
Current Update!!
1. A 3-year-old child is diagnosed with pediculosis capitis. What is the
recommended initial treatment?
A. Oral ivermectin
B. Lindane shampoo
C. Permethrin 1% topical lotion
D. Malathion 0.5% lotion
Correct Answer: C. Permethrin 1% topical lotion
2. A 7-month-old infant has had two prior episodes of acute otitis media
and is currently on day 10 of amoxicillin-clavulanate after failure of
amoxicillin. Examination reveals persistent middle ear effusion and
erythematous tympanic membranes. The infant is irritable with a
temperature of 99.8°F (37.7°C). What is the next step in management?
A. Switch to oral azithromycin
B. Administer intramuscular ceftriaxone
C. Continue antibiotics for an additional 7 days
D. Refer the child to an otolaryngologist
Correct Answer: D. Refer the child to an otolaryngologist
,3. A child presents with bilateral ear itching, hearing difficulty,
periauricular edema, and marked swelling of the external auditory canal.
Severe pain is elicited with manipulation of the auricle. What is the most
appropriate intervention?
A. Oral amoxicillin
B. Oral antihistamines
C. Ototopical antibiotic-corticosteroid drops
D. Ear irrigation
Correct Answer: C. Ototopical antibiotic-corticosteroid drops
4. A child previously treated with amoxicillin followed by amoxicillin-
clavulanate for acute otitis media is seen for follow-up. Examination shows
dull gray tympanic membranes with a visible air-fluid level. The child is
afebrile and asymptomatic. What is the appropriate next action?
A. Begin a third course of antibiotics
B. Refer to otolaryngology immediately
C. Monitor the middle ear effusion for up to 3 months
D. Prescribe antihistamines and decongestants
Correct Answer: C. Monitor the middle ear effusion for up to 3 months
5. A school-age child with a history of chronic otitis media presents with
vertigo. Examination reveals profuse purulent otorrhea from pressure-
equalizing tubes and a pearly white lesion on the tympanic membrane.
What is the most likely diagnosis?
A. Otitis externa
B. Mastoiditis
C. Tympanosclerosis
D. Cholesteatoma
Correct Answer: D. Cholesteatoma
6. What teaching should the Family Nurse Practitioner provide to parents of
a child who has new pressure-equalizing tubes (PETs) placed in both ears?
, A. Water exposure must be avoided at all times
B. Recurrent ear infections will never occur again
C. Hearing improvement should be expected
D. Tubes must be surgically removed within 6 months
Correct Answer: C. Hearing improvement should be expected
7. A nurse practitioner observes multiple oval macules, both
hyperpigmented and hypopigmented, on a child’s upper trunk. A fine scale
is noted at the borders of the lesions. What is the most likely diagnosis?
A. Vitiligo
B. Pityriasis rosea
C. Tinea versicolor
D. Atopic dermatitis
Correct Answer: C. Tinea versicolor
- tinea versicolor is a common dermatosis characterized by multiple small,
oval, scaly patches measuring 1-3 cm in diameter, usually located in a
raindrop pattern on the upper chest, back, and proximal portions of the
upper extremities. In children, atopic dermatitis lesions are typically dry,
papular, and intensely pruritic. Circumcised scaly patches are distributed on
the wrists, ankles, and antecubital and popliteal fossa.
- Keratosis pilaris is typically distributed on the posterior upper portion of the
arms and lesions are dry and papular.
- With Pityriasis rosea, a prodrome of malaise, headache, and mild
constitutional symptoms occasionally precedes the rash but it's not crucial
for diagnosis. The typical eruption begins with the appearance of one or
multiple "Herald patches" which are large, isolated, oval lesions, usually
pink in color and slightly scaly. They may occur anywhere on the body. From
5 to 10 days later, other smaller oval lesions appear on the body, frequently
concentrated over the truck but also seen on the proximal extremities,
especially the thighs
, 8. The NP is examining a 6-week-old infant of Latin American descent. There
are irregular areas of Deep Blue pigmentation across the infant's buttocks.
This would be identified as a characteristic of: - ANSWER Mongolian
spots;
- this best describes Mongolian spots, which are characteristic in newborns
of African, Asian, or Latin descent. When closely evaluated, these but do
not resemble the ecchymosis that occurs with trauma. Telangiectatic nevi
are commonly known as "stork bites" and our deep pink lesions most often
found on the back of the neck. Cutis marmorata is the transient mottling
that occurs when an infant is cold
9. A new mother is concerned about the Hemangioma on her infant's neck.
What is the treatment of choice for the majority of infants with
hemangioma? - ANSWER Observation
- the most common treatment is observation because most hemangiomas
resolve over time, usually beginning at about 18 months of age. The other
treatments may be perform, especially for hemangiomas proliferating rapidly.
Treatment with Propranolol, topical, or laser therapy may be used. Propranolol
is generally initiated inpatient, with nursing supervision of blood pressure and
heart rate and blood glucose.
10.A mother brings her preschool child to see the FNP because of sores on his
arms and legs. On exam, the FNP notes several honey-colored crusted
lesions within an erythematous base on the arms and legs. There's a history
of exposure to mosquitoes. The rest of the exam is essentially negative.
What is the most likely diagnosis? - ANSWER impetigo; impetigo
presents with honey-colored crusted lesions with an erythematous base.
